Abstract
Idiopathic thrombocytopenic purpura (ITP) is an acute self-limited bleeding disorder that can progress to chronic form in 10–15% of the cases. Helicobacter pylori (H. pylori) infection is a possible cause of chronic ITP. We studied 30 children with resistant chronic ITP for H. pylori infection based on the detection of H. pylori fecal antigen. This retrospective study was based on data obtained from medical records of 30 children aged between five and 17 years (median age at ITP diagnosis was ten years). A specially-designed data sheet was used to record information on age, sex, duration of disease, family history of bleeding disorders, previous treatments and median platelet count. In patients with H. pylori infection, antimicrobial treatment consisted of amoxicillin, metronidazol and omeprazol. Response was assessed every month for one year and defined as complete (platelet count >150×109/L) or partial (platelet count between 50 and 150×109/L). We detected H. pylori infection in 5 patients. In 4 of them increased platelet count was seen during one year of follow-up and in one patient the platelet count was acceptable during six months. Although the pathological mechanism of H. pylori-induced thrombocytopenia was unclear in our patient sample, the assessment of H. pylori infection and use of eradication therapy should be attempted in chronic and resistant ITP patients.
Highlights
During the follow-up period, patients did (Wilcoxon’s signed rank test) and 0.001 not receive any medication
Topenia was unclear in our patient sample, H. pylori eradication, which was confirmed by After H. pylori was eradicated in patients the assessment of H. pylori infection and use the disappearance of H. pylori antigen from with the infection, platelet count was of eradication therapy should be attempted in stool
The investigation and eradication of H. pylori infection in children with chronic Idiopathic thrombocytopenic purpura (ITP) is a matter of debate, there are few ly reports about children with this disease
Summary
Shashok (AuthorAID in the Eastern Mediterranean) for editorial assistance This retrospective study involved 30 chil- Contributions: MM, contributed to the conception dren with chronic ITP younger than 18 years and design, data acquisition and analysis, and Abstract of age referred consecutively to the Motahari interpretation of the data, drafted the article and Outpatient Pediatric Clinic of Shiraz revised it critically for important intellectual content; MS, provided final approval of the version to Idiopathic thrombocytopenic purpura (ITP) is an acute self-limited bleeding disorder that ly can progress to chronic form in 10-15% of the cases. We o studied 30 children with resistant chronic ITP for H. pylori infection based on the detection e of H. pylori fecal antigen This retrospective s study was based on data obtained from medical records of 30 children aged between five u and 17 years (median age at ITP diagnosis l was ten years).
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